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	Cardiology, SCOPE OF CARE & GENERAL INFORMATION ROUTINE HOURS OF OPERATION 8:00 A.M. TILL 4:30 P.M. CARDIAC SERVICES: West Jefferson Medical Center was the first hospital in the region to offer 24/7 Emergency Room care and continues to mark firsts in advances in the care of patients with heart and vascular diseases. From new wireless technology in WJMC ambulances in the field to the Emergency Department staffed by board certified Emergency Room Physicians, to a state of the art catheterization laboratory and sophisticated diagnostic imaging such as a 64-Slice Cardiac CT Scanner, West Jefferson Medical Center is poised to provide the latest in cardiovascular care. Medical and surgical treatments are available at West Jefferson for heart and vascular conditions. Cardiologists and cardiovascular surgeons and other specialists are respected in the region and known nationally. WJMC recently was awarded a Get with the Guidelines Silver Performance Award for Stroke and Coronary Artery Disease as noted in US News and World Report. Members of the Medical Staff also serve on American Heart Association local and national committees and task forces. The new and recently introduced technology allows for wireless transmission of EKG tests from paramedics in the field directly to the ER at West Jefferson. WJMC officials anticipate the use of the new technology could shave valuable minutes off the national benchmark time of 90 minutes to get heart attack patients to lifesaving interventional treatment once they reach the hospital. This wireless EKG technology shortens delays to lifesaving treatment at the hospital by having paramedics wirelessly transmit the patient’s electrocardiogram data from the field or ambulance directly to the emergency room, where specialists use it to make faster diagnosis at West Jefferson. The time elapsed for each patient from arrival at the hospital to receiving treatment should be under 90 minutes, according to national guidelines recommended by the American Heart Association and the Joint Commission. Noninvasive diagnostic procedures at West Jeff include Holter monitoring (ambulatory device), cardiac echo and Doppler color flow studies, exercise echocardiography stress testing, pharmacologic stress echocardiography testing, treadmill exercise stress testing and Transesophageal echocardiography. Many heart and vascular procedures are performed at West Jefferson including angiography and interventional procedures, PTCA and balloon insertions, electrophysiology studies and catheter ablations, pacemakers and defibrillator procedures as well as Coronary Artery Bypass Grafts, valve surgeries and other interventional surgeries. West Jefferson offers CT Heart Scanning, calcium scoring and risk scoring; a Speakers Bureau and Cardiac Rehabilitation. To learn more about various cardiovascular diseases, click on the links below: Living with Hypertension Living with Coronary Artery Disease (CAD) Living with Congestive Heart Failure (CHF) Myocardial Infarction (MI) or Heart Attack Coronary Artery Bypass Graff (CABG) Living with Peripheral Vascular Disease (PVD) Click for information regarding Implantable Cardioverter Defibrillator (ICD). Click to learn more about Acute Coronary Syndrome. Click to learn more about The Pulse - Cardiac Service Line Newsletter Sept 2009. Click to learn more about The Pulse - Cardiac Service Line Newsletter Nov 2009. Click to learn more about The Pulse - Cardiac Service Line Newsletter Dec 2009. Click to learn more about American Heart Association Public Advocacy.
	EMERGENCY CARDIAC PROCEDURES: Cardiology is on call for emergency echocardiograms and color Doppler studies. IMAGING AND NON-IMAGING PROCEDURES: This department performs both imaging and non-imaging pro- cedures on a daily basis. CAPABILITIES: I. ELECTROCARDIOGRAM (EKG) An EKG is an atraumatic, non-invasive procedure that documents the electrical conduction of the heart from a variety of areas. There is virtually no patient preparation, and no contraindications. This procedure is performed on inpatients and outpatients of all ages. II. HOLTER MONITORING This procedure records the heart rhythm and electrical activity of the heart for a 24 hour period. This recorded information is stored on an audio tape for viewing on a holter scanner that displays each heart beat and makes many measurements such as intervals, rate, and elevations. A diary is kept by the patient to correlate symptoms with specific cardiac activity. This again is an atraumatic non-invasive procedure with no side effects or patient preparation. This procedure is suitable to both inpatients and outpatients of all ages. III. 2D ECHOCARDIOGRAPHY This is a non-invasive scanning procedure that uses ultrasound to image the heart from various positions that are recorded on both video tape and hard copy. This is then presented to a cardiologist for interpretation. This procedure requires little or no patient preparation and can be done on both inpatients and outpatients of any age. Information gathered from this procedure can be helpful in detecting the function and size of walls, chambers, and valves of the heart. IV. CARDIAC DOPPLER WITH COLOR FLOW This is a non-invasive method of monitoring blood flow through the cardiac structure. This procedure reveals blood flow direction and velocity with a color map and a graphical display of flow direction and intensity with simultaneous audio correlation. V. TRANSESOPHAGEAL ECHO (TEE) TEE is a procedure similar to an endoscope. A small flexible tube with an ultrasound probe mounted on the end is passed through the mouth and into the esophagus. From here the physician can manipulate the transducer to better visualize certain structures such s valves, walls, descending aorta, atrial appendage, etc. for any abnormalities. This procedure does require a Cardiologist present to perform the procedure. Also, the patient must present with an empty stomach and have an IV in place for the administration of sedatives to relax them for the procedures. A topical anesthetic is also sprayed into the throat to ease the placement of the transducer into the esophagus. VI. C.V. MAX STRESS TEST This procedure evaluates a patient's cardiac electrical conduction while under the stress of walking on a treadmill at increasing speeds and elevations. A Cardiologist is present for this procedure, therefore, the non-cardiologist attending physician should arrange a cardiology consult. Patient preparation would include and empty stomach ie.nothing by mouth for at least four hours before the procedures. Male patients must have their chest shaved; in the areas for electrode placement once they arrive in the Cardiology department. Limitations would exclude anyone who could not walk on the treadmill because of physical limitations. This procedure is performed on both inpatients and outpatients in any age group within the limitations.
	Cardiac Rehabilitation Cardiac Rehabilitation is a program at West Jefferson Medical Center dedicated to care for adult patients who have been diagnosed with cardiovascular disease. The purpose of the department is to limit and to reduce the physiologic and psychological effects of cardiovascular disease. Nurses and specialists in Cardiac Rehab work to improve patients’ cardiovascular fitness, assist the patient and family to gain a better understanding of cardiovascular diseases and to assist in risk factor modification. The department thrives with strong physician support and referrals and the active participation of patients and their loved ones. The Medical Director for the Cardiac Rehabilitation Program is Charles Everson, M.D. The staff consists of nurses Dawn Delaune, Paulette Dufrene, Debbie Howard, and Anne Meerman, and clinical exercise physiologist Stacy Richoux. “Education is the ‘heart’ of this department,” said Meerman. “Phase I is targeted to the cardiac patient in the hospital. With the open heart patient, we often see them for pre-op education, to answer their questions and to help alleviate their fears. For other patients, our interaction begins at the bedside, which includes range of motion exercises one day post-op. Education includes anatomy, risk factor modification, dietary and discharge instructions and a guide for home exercise until they are able to enter our outpatient program.” Phases II and III are the outpatient components of the cardiac rehabilitation program. “The supervised exercise program is important, but the continuing education is really the most significant aspect. We work with each patient, encouraging them to make healthy lifestyle changes…and hopefully prevent future heart-related problems,” said Meerman. To learn more about our program, patients and families can call 349-6180.
	ICD (Implantable Cardioverter Defibrillator) Tachyarrhythmias (rapid heart rate) may result from coronary artery disease, heart attack, or cardiomyopathy (heart muscle disease). One of the most serious tachyarrhythmias, is ventricular tachycardia (VT). When VT occurs, blood is not pumped out of the heart efficiently and rapid contractions of the heart prevent it from filling adequately. This results in less blood to the brain, which causes dizziness and possible loss of consciousness. VT can be dangerous and life threatening if not treated. When ventricular arrhythmias become unstable, ventricular fibrillation (VF) occurs. During VF, the heart quivers and does not pump blood out, resulting in cardiac arrest. Cardiac arrest occurs without warning. Emergency teams and external defibrillators may not be available in the first moments of cardiac arrest, especially in situations occurring outside of the hospital. The ICD is implanted in persons who have experienced a cardiac arrest and/or who have met specific cardiac criteria. The device contains an internal defibrillator and pacemaker. The defibrillator acts as a monitor during the first critical seconds of cardiac arrest. When the heart goes into a tachyarrhythmia, the device analyzes the rhythm and delivers the programmed therapies to end VT or VF. ©2009 wjmc.org. All rights reserved.